Organization Active NPI

Mervin J. Weis & Bruce L. Ferguson MD, SC

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1821218793
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MERVIN J. WEIS & BRUCE L. FERGUSON MD, SC
Practice address
4640 N Marine Dr
Ste C 6100
Chicago, IL 60640-5719
Phone
(773) 769-4413
Fax
(773) 769-5140
NPI assigned
Apr 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Bruce L. Ferguson, MD
Title
Doctor
Phone
(773) 769-4413

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X IL Primary

Addresses

Primary practice location

4640 N Marine Dr
Ste C 6100
Chicago, IL 60640-5719

Mailing address

4640 N Marine Dr
Ste C 6100
Chicago, IL 60640-5719
Phone (773) 769-4413

National Provider Directory

National Provider Directory

Locations

4640 N Marine Dr
Ste C
Chicago, IL 60640
Phone (773) 769-4413

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821218793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4640 N MARINE DR",
            "address_2": "STE C 6100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405719",
            "telephone_number": "773-769-4413",
            "fax_number": "773-769-5140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 N MARINE DR",
            "address_2": "STE C 6100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606405719",
            "telephone_number": "773-769-4413",
            "fax_number": "773-769-5140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERVIN J. WEIS & BRUCE L. FERGUSON MD, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FERGUSON",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "773-769-4413",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.